CYP1A2*F Polymorphism Contributes at Least Partially to the Variability of Plasma Levels of Dehydroaripiprazole, an Active Metabolite of Aripiprazole, in Schizophrenic Patients.

Takeshi Suzuki, Goyo Nagai, Kazuo Mihara, Yoko Tomori, Shoko Kagawa, Akifumi Nakamura, Kenji Nemoto, Tsuyoshi Kondo
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Abstract

Aim: The relationship between CYP1A2 polymorphisms and the steady-state plasma levels of aripiprazole and its active metabolite, dehydroaripiprazole, were investigated in Japanese schizophrenic patients.

Background: It has been implied that cytochrome P450 (CYP) 1A2 may play a role in the metabo-lism of aripiprazole. Genetic variations in the CYP1A2 gene have been reported.

Objective: The authors investigated the relationship between 2 CYP1A2 polymorphisms, CYP1A2*C (-3860G>A) and CYP1A2*F (-163C>A), and the steady-state plasma levels/dose (C/D) ratios of aripiprazole and dehydroaripiprazole in Japanese schizophrenic patients.

Methods: All 89 subjects (46 males and 43 females) had been receiving 2 fixed daily doses of aripiprazole (24 mg; n=56 and 12 mg: n=33) for more than 2 weeks. No other drugs were used except flunitrazepam and biperiden. The plasma drug levels were determined by LC/MS/MS. These CYP1A2 polymorphisms were detected using polymerase chain reaction analysis.

Results: The mean C/D ratios of dehydroaripiprazole were significantly (P < 0.05) lower in patients with the A/A allele of CYP1A2*F than in those without the allele. No differences were found in the values of aripiprazole and the combination of aripiprazole and dehydroaripiprazole among the CYP1A2*F genotype. There were no differences in the values of aripiprazole, dehydroaripiprazole, or the combination of the 2 compounds among the CYP1A2*C genotype. The absence of the A allele of CYP1A2*F was correlated with the mean C/D ratios of dehydroaripiprazole (standardized partial correlation coefficient = 0.276, P < 0.01) by multiple regression analysis.

Conclusion: The findings of this study suggest that the CYP1A2*F polymorphism contributes at least partially to the variability in the steady-state plasma levels of dehydroaripiprazole.

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CYP1A2*F多态性至少部分导致精神分裂症患者血浆阿立哌唑活性代谢产物脱氢阿立哌嗪水平的变异。
目的:研究日本精神分裂症患者CYP1A2多态性与阿立哌唑及其活性代谢产物脱氢阿立哌佐稳态血浆水平的关系。背景:细胞色素P450(CYP)1A2可能在阿立哌唑的代谢中发挥作用。CYP1A2基因的遗传变异已有报道。目的:研究日本精神分裂症患者CYP1A2多态性CYP1A2*C(-3860G>A)和CYP1A2*F(-163C>A)与阿立哌唑和脱氢阿立哌佐稳态血浆水平/剂量比(C/D)的关系。方法:所有89名受试者(46名男性和43名女性)接受了2周以上的阿立哌唑固定日剂量(24 mg;n=56和12 mg:n=33)。除氟硝西泮和比培林外,未使用其他药物。血浆药物水平采用LC/MS/MS测定。这些CYP1A2多态性是使用聚合酶链式反应分析检测的。结果:具有CYP1A2*F等位基因A/A的患者脱氢阿立哌唑的平均C/D比值显著低于没有CYP1A2*F等位位点的患者(P<0.05)。在CYP1A2*F基因型中,阿立哌唑以及阿立哌嗪和脱氢阿立哌佐的组合的值没有发现差异。CYP1A2*C基因型中阿立哌唑、脱氢阿立哌嗪或这两种化合物的组合的值没有差异。通过多元回归分析,CYP1A2*F的A等位基因缺失与脱氢阿立哌唑的平均C/D比率相关(标准偏相关系数=0.276,P<0.01)。结论:本研究结果表明,CYP1A2*F多态性至少部分导致脱氢阿立哌唑稳态血浆水平的变化。
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